Child-friendly design in paediatric healthcare environments: exploring children’s preferences for nature, space, and play

This study explores children’s socio-spatial preferences in paediatric healthcare environments, examining how and where children prefer to experience natural, built, and social elements. Cross-sectional survey data were collected from Iranian children aged 9-16 years with prior overnight hospitalisation experiences. The major finding was the frequent demand for access to gardens and nature-inspired scenes, especially green space and sky. Children preferred environments that grant them spatial control and autonomy, allowing active customisation, especially through social engagement. Children tended to socialise with their peers in spacious public spaces containing bright colours and natural elements that support playful opportunities for socialising. The study outlines three key strategies for child-friendly healthcare design: integrating nature as a fundamental component, fostering autonomy through adaptable spaces, and creating vibrant social areas that encourage play. Given that socio-spatial design cannot be effectively shaped by adult stakeholders alone, this study advocates for a transdisciplinary approach that includes children's perspectives in design and decision-making. This study contributes to supportive design theory by emphasising nature-based design and playfulness as a vital aspect of children's interaction with their surroundings, ultimately enhancing their well-being in hospital settings.